Laryngoscopes are widely known and used in the medical field to facilitate endotracheal intubation of a patient during an emergency situation to provide a positive air passageway for the mechanical ventilation of the lungs of the injured person. Such laryngoscopes are also used during surgical procedures to provide a passageway for the administration of anesthesia. In the human anatomy, the epiglottis normally overlies the glottis opening into the larynx to prevent the passage of food into the trachea during eating. Thus, when undertaking an endotracheal intubation, it is necessary to displace the epiglottis from the glottal opening to permit the air tube to be inserted into the trachea.
Various laryngoscope constructions are known. The more widely used laryngoscopes consist of an elongate, rigid metal blade which is supportably attached to a handle. These types of laryngoscopes are inserted through the mouth of the patient into the pharyngeal area to displace the tongue and epiglottis and permit direct visualization of the glottis through the mouth opening. Such laryngoscopes are generally provided with a light source which is directed along the blade to illuminate the area beyond the distal end of the blade.
The standard method for performing intubation of the trachea with conventional laryngoscope blades of the straight or slightly curved type is to place the patient in supine position, tilt the head backwards as far as possible, and distend the lower jaw to widely open the mouth. The blade is then inserted through the mouth into the throat passageway to displace the tongue and epiglottis and expose the glottis of the patient. The larynx is then viewed through the mouth opening from an observation position just above and behind the head of the patient by sighting generally along the axis of the blade. The endotracheal tube is inserted, either orally or transnasally, and passed alongside the blade through the glottis. The foregoing procedure is often made more difficult by the presence of bodily fluids on or in the larynx and trachea which significantly reduce the visibility when using conventional systems.
The safety and efficacy of procedures for introducing tubular members in the body can be greatly enhanced with the use of remote visualization, where for example, a distal end of an endoscope is introduced in the body to permit visualization of the procedures via an eyepiece of the endoscope optically coupled with an image receiving distal end. Introduction of tubular members with the assistance of remote visualization is highly desirable for various medical procedures; however, even with the assistance of remote visualization, many medical procedures involving introduction of tubular members remain difficult to perform and carry a risk of adverse consequences for the patient. In particular, it is difficult when introducing tubular members into the body to obtain accurate, clear exposure of sites in the body, such as the trachea, through which the tubular members are introduced. Without proper positioning and guidance, the tubular members often cause trauma or injury to anatomical tissue.
Surgical instruments having means for indirect illumination and visualization of the pharyngeal areas of the body are also known. U.S. Pat. Nos. 3,776,222 and 3,913,568 disclose devices for endotracheal intubation which comprise flexible or articulatable tubular probes having internal fiber optics for lighting and viewing the internal areas of the body. As disclosed in those patents, the probes carry a slidably removable endotracheal tube surrounding their outer surfaces and the probe is directly inserted into the trachea to position the tube. Such devices obviously require the use of relatively large diameter endotracheal tubes in order to be carried on the tubular probe, and their use necessarily is limited to patients with sufficiently large airway passages to accommodate the combined size of the probe and endotracheal tube. Additionally, due to the flexible nature of the probes, it is difficult to manipulate the probe to displace the tongue and epiglottis to permit direct insertion of the tube into the trachea.
As a consequence, there has been a long felt need for a device which can facilitate intubation so as to easily and quickly accomplish direct laryngoscopic intubation. There is a further need for such a device which is inexpensive enough to be financially accessible for any emergency vehicle. There is further also a need for such a device which enables indirect visualization of a patient's airway from a 360 degree vantage point.